Explore the vast range of titles available.

Bee pollen is made by honey bees (Apis Mellifera) from the pollen of plants and flowers and represents an apiary product enriched in essential amino acids, polyphenols, omega-3, and omega-6 fatty acids. This study investigated the botanical origin, micronutrient profile, and antioxidant activity of bee pollen samples (n = 10) harvested in Lucca and Massa Carrara (Tuscany, Italy) between 2016 and 2017. The palynological analysis showed that bee pollen samples were composed of nine botanical families. Front-face fluorescence spectroscopy was performed on bee pollen samples in bulk, without any treatment, and in ethanol extracts to determine the characteristic fluorescent profile and, to identify the main chemical compounds with biological activity. The main chemical compounds detected were polyphenols (mainly flavonoids and phenolic acids), hydro-soluble vitamins (B2, B3, B6, and B9), amino acids, and pigments. Furthermore, the antioxidant activity was investigated, and one of the two Viburnum pollens resulted in the highest polyphenols and flavonoids content (20.15 ± 0.15 mg GAE/g fw and 23.46 ± 0.08 mg CE/g fw, respectively). However, Prunus and Eucalyptus families showed the highest in vitro (190.27 ± 8.30 µmol Fe2+/g) and ex vivo (54.61 ± 8.51 CAA unit) antioxidant capacity, respectively. These results suggested that Tuscan bee pollen, depending on the botanical family, is rich in essential nutrients and potential nutraceutical product.

Mycoprotein is a fungal-derived ingredient used for meat alternative products whose fungal cell walls are rich in dietary fibre (β-glucans and chitin) and defines its structure. Several health benefits have been reported after mycoprotein consumption, however, little is known about the impact of mycoprotein fermentation on the gut microbiota. This study aims to identify changes in microbiome composition and microbial metabolites during colonic fermentation of mycoprotein following simulated upper gastrointestinal digestion. Changes in microbial populations and metabolites produced by the fermentation of mycoprotein fibre were investigated and compared to a plant (oat bran) and an animal (chicken) comparator. In this model fermentation system, mycoprotein and oat showed different but marked changes in the microbial population compared to chicken, which showed minimal differentiation. In particular, Bacteroides species known for degrading β-glucans were found in abundance following fermentation of mycoprotein fibre. Mycoprotein fermentation resulted in short-chain fatty acid production comparable with oat and chicken at 72 h. Significantly higher branched-chain amino acids were observed following chicken fermentation. This study suggests that the colonic fermentation of mycoprotein can promote changes in the colonic microbial profile. These results highlight the impact that the unique structure of mycoprotein can have on digestive processes and the gut microbiota. An in vitro model of upper gastrointestinal digestion approach identifies changes in microbiome composition and microbial metabolites during simulated colonic fermentation, and implicates several Bacteroides species in the process.

Mycoprotein is a food ingredient comprising intact fungal cells, rich in protein and fibre. Clinical trials have shown that mycoprotein reduces blood lipids and increase insulin sensitivity, and the protein contained within the hyphal cells is highly bioavailable. However, the mechanisms underlying these effects are not clearly understood. This thesis aimed to investigate the simulated digestion of mycoprotein to understand its protein bioaccessibility and the impact on digestive enzymes and macronutrients involved in carbohydrate and lipid digestion. Furthermore, the release of -glucans and minor compounds (i.e., ergothioneine and phenolic acids) from the mycoprotein cell walls was investigated, as well as the colonic fermentation of mycoprotein following gastrointestinal in vitro digestion. The simulated digestion of mycoprotein showed that proteins were released from the fungal matrix and digestive enzymes such as -amylase, remained entrapped within hyphal cells by diffusing through the cell wall, which resulted in a reduced carbohydrate digestion (75% lower with 20 mg/mL of mycoprotein compared to the control; p-value < 0.001). Moreover, mycoprotein reduced lipid digestion by lowering enzymatic lipolysis (38% lower compared to the control; p-value < 0.001) and binding bile salts. Although the cell walls remained intact after gastrointestinal digestion, -glucans (56.52 ± 5.14%) were released from the cell walls (p-value < 0.01) if mycoprotein was previously cooked. Notwithstanding, the cell walls maintained their shape, and only colonic bacteria degraded its structure by fermenting its fibre and producing short-chain fatty acids. Minor compounds that could have played a role in promoting health benefits were not detected, except for ergothioneine, which deserves future research. The findings presented in this thesis describes the behaviour of mycoprotein during simulated gastrointestinal digestion and proposes biochemical mechanisms associated with physiological processes that can promote health effects. Understanding these mechanisms is essential to developing new products and strategies to improve human health.

(1) Background: Foreign body aspiration (FBA) is a significant public health concern among the pediatric population, and fatalities are dramatic for families. It typically involves organic foreign bodies (mainly food) aspirated by children under three years old, usually at home or school. This review aimed to focus on the preventive measures around four actual cases of fatal foreign body aspiration, emphasizing the correct execution of the Heimlich maneuver and cardiopulmonary resuscitation, supervised mealtimes, and high-risk foods. (2) Methods: Four fatal cases of foreign body aspiration in children are presented here. The children were in a free environment, such as school, home, and the countryside, and were in the presence of teachers, parents, and a grandmother who did not supervise the children adequately. A literature review was performed via the MEDLINE database using the key terms: “foreign body aspiration,” “infant choking, 1.5 to 3 years,” “food and foreign body aspiration,” “common household,” “prevention of foreign body aspiration,” “guidelines,” “recommendations,” “training of caregivers (parents, educators),” “resuscitation,” “Heimlich maneuver,” and “disengagement of the upper airways.” We focused on the prevention of foreign body aspiration. (3) Results: a complete postmortem examination was performed. In three cases, the foreign bodies were food (mozzarella cheese, pear, or raw bean), while in one case, the foreign body was a pebble. (4) Conclusions: This review aimed to discuss recent scientific literature and provide a perspective on the benefits of a dedicated approach to the management of fatal foreign body aspiration in children by caregivers who usually have no experience with the best ways of supervising children in a safe environment, especially regarding the correct execution of resuscitation maneuvers, such as the Heimlich maneuver. Recommendation updates could improve healthcare quality in a pediatric setting and reduce medico-legal implications.

The COVID-19 pandemic is impressively challenging the healthcare system. Several prognostic models have been validated but few of them are implemented in daily practice. The objective of the study was to validate a machine-learning risk prediction model using easy-to-obtain parameters to help to identify patients with COVID-19 who are at higher risk of death. The training cohort included all patients admitted to Fondazione Policlinico Gemelli with COVID-19 from March 5, 2020, to November 5, 2020. Afterward, the model was tested on all patients admitted to the same hospital with COVID-19 from November 6, 2020, to February 5, 2021. The primary outcome was in-hospital case-fatality risk. The out-of-sample performance of the model was estimated from the training set in terms of Area under the Receiving Operator Curve (AUROC) and classification matrix statistics by averaging the results of fivefold cross validation repeated 3-times and comparing the results with those obtained on the test set. An explanation analysis of the model, based on the SHapley Additive exPlanations (SHAP), is also presented. To assess the subsequent time evolution, the change in paO2/FiO2 (P/F) at 48 h after the baseline measurement was plotted against its baseline value. Among the 921 patients included in the training cohort, 120 died (13%). Variables selected for the model were age, platelet count, SpO2, blood urea nitrogen (BUN), hemoglobin, C-reactive protein, neutrophil count, and sodium. The results of the fivefold cross-validation repeated 3-times gave AUROC of 0.87, and statistics of the classification matrix to the Youden index as follows: sensitivity 0.840, specificity 0.774, negative predictive value 0.971. Then, the model was tested on a new population (n = 1463) in which the case-fatality rate was 22.6%. The test model showed AUROC 0.818, sensitivity 0.813, specificity 0.650, negative predictive value 0.922. Considering the first quartile of the predicted risk score (low-risk score group), the case-fatality rate was 1.6%, 17.8% in the second and third quartile (high-risk score group) and 53.5% in the fourth quartile (very high-risk score group). The three risk score groups showed good discrimination for the P/F value at admission, and a positive correlation was found for the low-risk class to P/F at 48 h after admission (adjusted R-squared = 0.48). We developed a predictive model of death for people with SARS-CoV-2 infection by including only easy-to-obtain variables (abnormal blood count, BUN, C-reactive protein, sodium and lower SpO2). It demonstrated good accuracy and high power of discrimination. The simplicity of the model makes the risk prediction applicable for patients in the Emergency Department, or during hospitalization. Although it is reasonable to assume that the model is also applicable in not-hospitalized persons, only appropriate studies can assess the accuracy of the model also for persons at home.

A 41-year-old caucasian male was referred to the Glaucoma clinic at our tertiary referral centre with a diagnosis of normal tension glaucoma after the finding of increased bilateral asymmetrical cup/disc ratios, with normal intraocular pressures. On examination, the authors confirmed the presence of bilateral reduced optic disc rims alongside a left pale residual rim, and a further discovered a positive dyschromatopsia with a bilateral visual field alteration. The left visual field showed a relative scotoma confined to the vertical midline. After initiating investigation for suspected glaucoma, the authors ordered a magnetic resonance imaging that evidenced an internal carotid aneurysm along the ophthalmic segment, stretching across the optic chiasm with a major involvement of the left optic nerve and partial involvement of the right optic nerve. Aneurysm embolisation was performed with complete resolution of signs and symptoms achieved 5 months post-operatively. Despite glaucoma being the most frequent condition causing optic disc atrophy and visual field loss, it is not the only cause. Any atypical visual field defect not in keeping with a glaucomatous field loss should be further investigated. The ophthalmologist should thoroughly assess all signs that could lead to different diagnosis.